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Eyes Wide Shut – January, 2014 Meaningful Use Stage 2 Readiness Reality Check

Posted on January 13, 2014 I Written By

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Happy New Year?

As I begin the 2014 Meaningful Use measures readiness assessment and vendor cat-herding exercises, I’m reflecting on this portion of CMS’s Director of E-Health Standards and Services, Robert Tagalicod and the ONC’s Acting National Coordinator Jacob Reider’s statement regarding the Meaningful Use timeline modification: “The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2.” (Previously published on EMRandHIPAA.com.)

I call BS.

If the “goal” is a “successful implementation”, then CMS failed miserably by not addressing the START of the quarterly attestation period for Stage 2, which is still required in 2014. CMS and the ONC need more time to successfully implement the measures, and they are bureaucratic agencies that don’t directly deal with patient medical care. Why wasn’t the additional time required to truly succeed at this monumental task extended to the healthcare provider organizations? Because the agencies want to save face, and avoid litigation from early adopters who may be already beginning their 2014 attestation period amidst heroic back-breaking efforts?

Here’s a reality check for what a large IDN might be going through in early January, in preparation for the start of the 2014 quarterly attestation period. Assume this particular IDN’s hospitals’ fiscal year runs October-September, so you MUST begin your attestation period on July 1. You have 6 months.

As of December 31, 2013, only 4 of the 8 EMRs in your environment completed their 2014 CEHRT certification.

Each of those 4 EMRs has a different schedule to implement the upgrade to the certified edition, with staggered delivery dates from March to July. The hospital EMR is not scheduled to receive its certified-edition upgrade until April. You pray that THIS implementation is the exception to your extensive experience with EMR vendor target timelines extending 6-8 weeks beyond initial dates.

The EMR upgrades do not include the Direct module configuration, and the vendor’s Direct module resources are not available until 6-9 weeks after the baseline upgrade implementation – if they have knowledgeable resources, at all. Your hospital EMR vendor can’t articulate the technical infrastructure required to implement and support its own Direct module. Several vendors indicate that the Direct module configuration will have to be negotiated with a third-party. Your clinicians don’t know what Direct is. Your IT staff doesn’t know how to register with a HISP. Your EMR vendor doesn’t support a central Direct address directory or a lookup function, so you contemplate typing classes for your HIM and clinical staff.

The number of active patient problems requiring manual SNOMED remediation exceeds 60,000 records in your hospital EMR. You form a clinical committee to address, but they’re estimating it will take 6 months of review to complete. You’re contemplating de-activating all problems older than a certain date, which would whittle down the number and shorten the timeframe to complete – but would eliminate chronic conditions.

There are still nagging questions regarding CMS interpretation of the measures, so you ask for clarification, and you wait. And wait. And wait. The answers impact the business rules required for attestation reporting, and you know you need any help you can get in whittling down the denominator values. Do deceased patients count in the view/download/transmit denominator? If records access is prohibited by state/federal law, does that encounter count in the view/download/transmit denominator?

Consultant costs skyrocket as you struggle to find qualified SME resources to blaze a trail for your internal staff. Their 60-to-90-day assessments inevitably end with recommendations for “proof of concept” and “pilot” approaches to each of the 2014 measures, which don’t take into account the reality of the EMR upgrade timelines and the looming attestation start date. Following their recommendations would delay your attestation start by 9-12 months. So, your internal staff trudges forward without expert leadership, and you throw the latest PowerPoint deck from “Health IT Professionals-R-Us” on the pile.

Who needs testing, when you can go live with unproven technology the day it’s available in order to meet an arbitrary deadline? Healthcare.gov did it – look what a success that turned out to be!

But wait, this is real clinical data, generated by real-world clinical workflows, being used to treat real patients, by real healthcare providers. By refusing to address the start of the 2014 attestation period, CMS and the ONC are effectively using these patients and providers as lab rats.

I did not give permission to be part of this experiment.

HIMSS Attire Day 2 – Top 10 Real Reasons I’m at HIMSS11

Posted on February 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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Today I have a special shirt made just for HIMSS, thanks to the great people at Enterprise Software Deployment.

If you see me at HIMSS, check out my shirt. It has the top 10 real reasons I’m at HIMSS listed on the back of the shirt. My favorite is #4 Booth babes. I’ll post the full top 10 later tonight.

Also, be sure to check out Enterprise Software Deployment at HIMSS if you need a great EMR consultant or if you’re looking for a position doing EMR consulting. You can find them at Booth #2777.

Here’s their HIMSS exhibitor description:
At ESD, our goal is to ensure successful implementation of a new EHR system or upgrade from start to finish in healthcare organizations around the globe. Our services include Clinical Transformation, Legacy System Support, Training, Supplemental Staff Augmentations, Clinical and System Transformation, as well as education and training in all aspects of Cerner®, Siemens®, Epic®, Eclipsys®, MEDITECH, and McKesson systems.

Thanks for ESD for sponsoring such a cool shirt for me.

Advice for EMR Selection Consultants

Posted on March 19, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A recent comment asked me what I thought about this person becoming essentially an EMR selection consultant. I started to reply in the comment, but it got so long that I decided that it was worthy of it’s own post. Plus, then all the EMR and HIPAA readers can provide other counsel and advice in the comments which will probably be even more valuable than what I have to offer.

Considering so many people are losing jobs and searching for new emr jobs (no, I wasn’t paid for that link, but I was paid for the EMR Jobs ad on this page), I think this post is timely. So, the follow is my advice to Jim about becoming an EMR selection consultant.

Jim,
I think there are a lot of doctors that could use this type of service. There are 4 things I think our worth mentioning to you.

1. Are doctors going to be willing to pay much for this type of service? It’s certainly a valuable service, but do doctors see this as necessary and worthwhile or do they think they can just do it on their own using some certification or recommendations from friends, organizations, associations, etc. In these economic times, don’t be surprised if many of them aren’t ready to spend money on this either.

2. Why should doctors trust you with this decision? I’m not speaking of you specifically since I don’t know you. My point is that this is a HUGE decision by a doctor. How will you make the doctors feel enough trust in you to have them help you make the decision? Once you earn their trust, it’s gold.

3. Many doctors are just browsing for EMR software. Be sure that whatever contract you create with the doctor, it’s clearly specified what your responsibilities are and what the doctors responsibilities are as well. They’ll HAVE to play a major part in the selection process. However, you don’t want to be stuck ready to go through the process and they’re not willing to commit the time. Then, you’ve wasted your time and won’t get paid. Also, don’t fall in the trap that they have to select the EMR for you to get paid. Otherwise, the doctors will just spin their wheels on the decision making and you won’t get paid for much longer than you planned.

4. Be very clear about any conflict of interests you may have. Try to avoid having conflict of interests at all. However, it’s sometimes too nice to not get paid a referral from an EMR vendor when you’re the one that sent them the business. You’ll have to work that through yourself. However, I ethically believe if you are getting paid to help someone select an EMR, they should be made fully aware of any conflict of interests you may have in your pocket. Now, if we could just get our government leaders to do the same (but I digress).

I know there are many other things, but I hope this helps. I really think there’s going to be a lot of work in the area of EMR selection for a while to come.

My Article on Understanding the Types of EHR Consultants

Posted on February 24, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I mentioned previously that I was working on an article about EHR consultants. I wanted to sincerely thank all those people who commented on EHR consultants and sent me feedback on things I should include in my article.

As you’ll see, I used a lot of the feedback that you gave me to form the article. That’s really the power of the internet to bring a bunch of bright people together to create something of far greater value than I could have created on my own. Thank you for your feedback.

I’m told the Magazine has been sent to the presses and those of you who get MDNG magazine will see my article soon (hopefully someone will get one to me). The cool thing is that my article is the cover story for the February issue of MDNG.

For those that don’t want to wait for the magazine or don’t get the magazine, my article on EHR consultants has already been posted online. It’s called: Does Your EHR Consultant Have Your Best Interests in Mind?

Let me know what you think about it.

EHR Consultants – The Good, The Bad and The Ugly

Posted on December 18, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I know that I have a number of EHR consultants that regularly read this blog. Plus, many of my readers have used, are looking to use or have heard stories about EHR consultants. I’m currently working on an article about EHR Consultants and so I’m interested in hearing people’s feedback about their experience with or as an EHR consultant. Here’s some things i’m interested in hearing about:

  • Benefits of an EHR Consultant
  • Challenges of an EHR Consultant
  • Finding a good EHR Consultant
  • Making the most of an EHR Consultant
  • Does an unbiased EHR Consultant exist?
  • etc…

Basically, I’m interested in answering the question of whether an EHR consultant has your best interest in mind and things you can do to ensure a quality experience with a consultant.

Also, you might look back at my five part series on EHR consultants to get you thinking.

Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Posted on January 19, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Part five of our five part series on the benefits of an EMR or EHR consultant is improved clinical buy-in.

Improved Clinical Buy-In

Hiring a proven EMR consultant alleviates fear and increases clinical buy in. However, more importantly, EMR consultants are able to provide a clinic the tools needed to show an EMR implementation’s ROI. EMR consultants should do a comprehensive analysis to show how an EMR implementation will reduce costs, increase revenues, and better care for patients. Quantifying the potential returns on an EMR investment generates significant buy in at all levels of a clinical organization.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support

Posted on January 18, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Part four of our five part series on the benefits of an EMR or EHR consultant is comprehensive technology support.

Comprehensive Technology Support

By providing a comprehensive set of technology support, a technical EMR consultant can alleviate doctor’s concern over the implementation of new technology. An EMR consultant’s proven track record of implementing these health care related technologies in doctors’ offices allows them to do it in a robust, efficient, and cost effective manner. Doctors save time searching through the numerous technology choices because EMR consultants can point them to the best brand of technology or even to technologies the doctor didn’t know existed.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping

Posted on January 16, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Part three of our five part series on the benefits of an EMR or EHR consultant is clinical process mapping.

Clinical Process Mapping

One of the hardest things for a doctor new to EMR to do is see how their current clinical processes will work electronically in an EMR. To alleviate this fear, EMR consultants can first map out a doctor’s clinical processes. They can then use their experience with other EMR implementations and show how current clinical processes will be done using an EMR. This will save doctors a lot of time mapping out these processes. It also provides a clear understanding of what a doctor’s clinic will look like electronically. However, the most important part of this process is that it provides a way to find problems that may occur with an EMR before you’ve actually implemented.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Benefits of Using an EMR/EHR Consultant – EMR Training

Posted on January 12, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Part two of our five part series on the benefits of an EMR or EHR consultant is EMR Training.

EMR Training

Using an EMR consultant’s experience in successful EMR implementations, they have a strong ability to train doctors on EMR and other related technologies. Some of this training occurs in an initial meeting where they discuss challenges related to EMR selection and implementation. EMR consultants also provide ongoing training on how to best use their EMR in their clinic. Furthermore, EMR consultants can train clinical staff on using the various technologies associated with using an EMR.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Benefits of Using an EMR/EHR Consultant – Selection Process

Posted on January 11, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A while back I wrote something about why having an EMR or EHR consultant could be beneficial to a doctor looking to implement an EHR. Here’s the first part of a five part series on reasons why I think a well qualified, experienced EMR or EHR consultant is valuable. The first part is how an EMR or EHR consultant helps with the selection process.

EHR Selection Process

By first evaluating a doctor’s needs and preferences EHR consultants are able to eliminate a majority of the EHR companies and provide doctors with a short list of high quality EHR vendors to evaluate. By providing a smaller pool of EHR vendors, doctors are more comfortable with the selection process and don’t get discouraged seeing hundreds of EHR vendors that don’t meet their needs. EHR consultants also help doctors through the evaluation process. EHR consultants often provide a list of questions that can be used to evaluate EHR vendors. These questions have been designed to tease out information which will better enable doctors to select the right software. EHR consultants also assist doctors that need help negotiating with EHR vendors. These services include requesting enhancements to meet doctor specific needs or even ensuring that EHR vendor pricing is comparable to other EHR implementations.

When it comes down to it, a good EHR consultant can save a doctor large amounts of time and money that would have been wasted looking amongst the hundreds of EHR companies. It’s not hard to say that doctor’s most precious commodity is time.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in